On June 16, 1976, over 10, 000 black students marched on the streets of Soweto, South Africa to protest for their right to quality education. Unfortunately, they were met with brutal force, with hundreds shot and killed, and thousands others injured. In 1991, the African Union declared June 16 as the day of the African Child, commemorating the lives lost and recognizing the courage of those who marched for their rights to quality education.
On June 16th, young girls in Kenya called upon leaders to end teenage pregnancy, a problem robbing them of their right to education, and denying them of their life opportunities.
The teenage pregnancy crisis in Kenya
According to a recent report by UNFPA, 378,397 teenage pregnancies were recorded between July 2016 and June 2017, and 28, 932 of these pregnancies occurred among girls aged 10-14. Overall, one in five girls begins having children before their 19th birthday in Kenya according to data from the Ministry of Health. However, this overall average masks the in-country disparities of the magnitude of the problem. For instance, one in ten girls has begun childbearing in Elgeyo Marakwet, Murang’a, Nyeri, and Nyandarua counties, and four in ten girls have begun childbearing in Narok and Homa bay counties. These statistics are alarming given that only 2% of teenage mothers return to school.
The consequences of dropping out of school are grim and cyclical as it not only adversely affects the victims’ socio-economic wellbeing but their children too by limiting the resources available to cater for them. Teenage pregnancy is also a health issue given that the risks of premature birth, low birth weight, and perinatal death are higher among teenage mothers. Notably, most teenage pregnancies in Kenya are unintended, with over a third resulting in abortion. Teenage mothers are also at a high risk of developing complications and dying during childbirth. Adolescents’ heightened risk of sexual and reproductive health-related morbidity and mortality reflects, among others, their limited capacity to negotiate for safe sex and consent, prevent sexually transmitted diseases, lack of protection against sexual violence, and the lack of access to contraceptive information and services to prevent unplanned pregnancy.
How COVID-19 could worsen the problem of teenage pregnancy
The outbreak of the novel coronavirus disease has resulted in the deaths of 443, 685 people (as of June 17, 2020) globally and has led to the suspension of most economic activities devastating people’s means of livelihood. It has also led to the closure of learning institutions. In Kenya, the Ministry of Education has put in place strategies to ensure continuity of education through distance online learning delivered through radio, television and the Internet. However, these strategies have further widened the inequality gap, as learners from poor, vulnerable, and marginalized households are unable to benefit from continued learning through these platforms due to lack of access.
Further, with the loss of livelihoods particularly in low-income households, some children may be forced into income-generating activities to support their families’ survival. Also, school closure has stopped the provision of school meals and sanitary towels, which children from disadvantaged families rely on significantly. This raises the risks of young girls engaging in transactional sex in order to gain not only access to these essential needs but also to support their families. There is evidence that links poverty, lack of family support, and transactional sex.
Some of these pregnancies could be as a result of sexual violence, which has been projected to rise during COVID-19 lockdowns. At least, this is true judging from lessons learned during the Ebola outbreak in Sierra Leone and Liberia, where the closure of schools resulted in an increase in physical and sexual violence, teenage pregnancies, and unsafe abortions.
Aside from school closure, the rising cases of COVID-19 is likely to put a strain on the healthcare system, leading to the disruption of healthcare services, deprioritization of sexual and reproductive health services and shortage of contraceptive commodities and essential drugs. All these could lead to a rise in cases of teenage pregnancies. Young people have already reported reduced use of SRHR services including decreased access to contraceptives. Experts have projected that COVID-19 will lead to over 15 million additional unintended pregnancies globally, many of which will occur among teenage girls.
What must be done
The Kenya government committed to ending teenage pregnancy by 2030 at the ICPD 25 and began mobilising high-level intergovernmental committees to develop and implement proven solutions. These efforts ought to continue during this COVID-19 lockdown. Some of the commitments made include upholding the rights of young girls to sexuality education and provision of sexual and reproductive health services including contraceptives, as enshrined in the Maputo Protocol, and several national laws, policies and guidelines. Sexuality education which is part of the life-skills curriculum must be age-appropriate, and evidence-based emphasising both abstinence and safe sex practices including contraceptives information among those sexually active and must continue even during the lockdown when unintended pregnancies are projected to rise. Age-appropriate sexuality education must cover topics such as sexual consent, safe sex negotiation, healthy relationships, sexual and gender-based violence and reporting during the pandemic and beyond. Government in collaboration with relevant stakeholders should provide sessions for parents on how to address these topics with their children and to respond objectively to some of the misinformation and misconceptions around sexuality education.
Even though the Ministry of Health has developed guidelines on the continuity of reproductive, maternal, newborn, and family planning care and services , the guidelines do not explicitly address adolescents and young people. It is important for the Ministry to ensure that these sexual and reproductive health services are extended to adolescents and young people by clearly outlining this in the guidelines, and creating awareness among young populations on how and where to access such services.
We call on leaders to institute policy measures that ensure sexual and reproductive health services are accessible and affordable for all at this critical time. This will require adequate planning to ensure no stock-out of essential sexual and reproductive health products and expanding access to services and information especially through alternative channels such as telehealth. COVID-19 may exacerbate lack of access to sexual and reproductive health services, leading to increased teenage pregnancies. However, with committed leadership, the effects of the pandemic can be minimized, ensuring that the gains made in improving adolescent sexual and reproductive health before COVID-19 are not completely lost.